Are you a current smoker or a recent ex-smoker (i.e. since diagnosis)? |
Smoker/Recent ex-smoker |
How many cigarettes per day did you smoke over the 6Â months prior to diagnosis and how soon after waking did you smoke? |
Do you have at least one close family member who is either a current smoker or who stopped smoking after your diagnosis? Y/N |
Does your family member live with or apart from you? W/A |
Have you or your family member had any previous experience of using smoking cessation services? Patient Y/N Family member Y/N |
Are you or your family members currently considering smoking cessation? |
Patient Y/N Family member Y/N |
Stage Diagnosis stage/Treatment stage/Follow-up |
Period since diagnosis: |
Age |